خانه ارائه دهندگان و شرکا طرح مراقبت هماهنگ و Cal MediConnect

ابتکار مراقبت هماهنگ و Cal MediConnect

بازگشت به مراقبت یکپارچه برای ذینفعان واجد شرایط دوگانه

آیا شما عضو Cal MediConnect هستید؟ درباره آینده Cal MediConnect بیشتر بدانید.

Passage of the Coordinated Care Initiative (CCI) in July 2012 marked an important step toward transforming California’s Medi-Cal (Medicaid) care delivery system to better serve the state’s low-income seniors and persons with disabilities. Building upon many years of stakeholder discussions, the CCI begins the process of integrating delivery of medical, behavioral, and long-term care services and provides a road map to integrate Medicare and Medi-Cal for beneficiaries of both programs, called “dual eligible” beneficiaries.  

Created through a public process involving stakeholders and health care consumers, the CCI was enacted through Senate Bill 1008 (Chapter 33, Statutes of 2012) and Senate Bill 1036 (Chapter 45, Statutes of 2012).

The CCI was implemented in seven counties beginning in 2014. The seven counties are Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Clara.

بخش‌های اصلی ابتکار مراقبت هماهنگ

  • Cal MediConnect: یک طرح سلامت داوطلبانه برای ذینفعان دوگانه واجد شرایط برای دریافت خدمات هماهنگ پزشکی، رفتاری، سازمانی بلندمدت و خدمات مبتنی بر خانه و جامعه از طریق یک سیستم تحویل سازمان‌یافته واحد. Cal MediConnect مزایای Medicare و Medi-Cal را با مزایای اضافی هماهنگی مراقبت ترکیب می کند.  
  • پشتیبانی‌ها و خدمات طولانی‌مدت مدیریت‌شده Medi-Cal (MLTSS): همه ذینفعان Medi-Cal، از جمله ذینفعان واجد شرایط دوگانه، در شهرستان‌های CCI برای دریافت مزایای Medi-Cal خود، از جمله LTSS، ملزم به ملحق شدن به طرح سلامت مراقبت مدیریت‌شده Medi-Cal هستند. و مزایای کامل Medicare.

What’s New with Cal MediConnect

Under the California Advancing and Innovating Medi-Cal (CalAIM) initiative, starting on January 1, 2023, Cal MediConnect members will be transitioned to MMPs, or Medi-Medi Plans. MMPs is the California-specific program name for Exclusively Aligned Enrollment Dual Eligible Special Needs Plans (EAE D-SNPs). Under exclusively aligned enrollment, beneficiaries can enroll in a D-SNP for Medicare benefits and in a Medi-Cal managed care plan for Medi-Cal benefits, which are both operated by the same parent organization for better care coordination and integration. DHCS will work with health plans, stakeholders, and the Centers for Medicare & Medicaid Services (CMS) to transition and expand integrated care statewide.  This policy is intended to help meet the statewide goals of improved care integration and person-centered care, under both the CalAIM initiative and the California Master Plan for Aging.

DHCS is convening the monthly public CalAIM MLTSS & Duals Integration Workgroup to work with stakeholders to support this transition. Information on how to register for the CalAIM MLTSS & Duals Integration Stakeholder Workgroup, and background materials from previous workgroup meetings is available here.

اطلاعات کلی

  • How to Enroll – Shares basic information about how to enroll in Cal MediConnect.
  • Cal MediConnect Benefits and Services – Includes basic information about CMC’s benefits/services.
  • PACE – Includes brief background on the PACE program, a link to CalPACE, and four PACE FAQs.
  • Health Plan 101 – An explanation of different health plan components and a series of related questions and answers.

برگه اطلاعات CCI

  1. منابع برای ذینفعان

     2. منابع برای ارائه دهندگان

     3. منابع برای مدافعان

     4. اطلاعات تاریخی CCI

قانون مصوب

نسخه های پیشین زبان قانونگذاری

For more information about the Coordinated Care Initiative and Cal MediConnect, please visit the Integrated Care for Dual Eligible Beneficiaries webpage.